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As I See It

AS I SEE IT

Relocating an ASC is not easy. I can say this quite confidently as my facility completed a relocation in 2017. It was a substantial amount of work—and this was on top of a tragedy that tested the resolve of our entire staff and demonstrated firsthand the importance of careful planning.

While guidance for licensure proceedings, facility accreditation and Medicare certification is readily available to new ASCs, what ASCs new and old often overlook are the current and pending state regulations and constant shifts in the health care marketplace.

In March 2018, ASCA invited me to join One World Surgery at its ASC in Honduras to help kick off ASCA’s new scholarship program. The scholarship program is designed to help people who want to go on a medical mission trip but cannot finance the trip on their own. ASCA uses revenue derived from its affinity partners program to fund this scholarship program.

Historically, cardiology and vascular procedures were performed exclusively in a hospital setting. Nearly 20 years ago, however, many of these procedures began migrating to outpatient settings, such as renal dialysis centers, catheterization labs and endovascular labs, otherwise known as office-based vascular interventional laboratories (OBLs). The primary drivers for this movement included convenience, shorter appointment wait times and better outcomes for patients; greater control of technology and staffing, plus improved reimbursement, for physician owners of OBLs; and significant cost savings for payers.

In February 2000, President Bill Clinton officially dedicated the month of March as National Colorectal Cancer Awareness Month. Since then, it has grown to be a true rallying point for the colon cancer community. Every year, thousands of patients, survivors, caregivers and advocates throughout the community join together to spread colon cancer awareness by wearing blue, holding fundraising and educational events, and talking to friends and family about screening.

According to §416.52 Conditions for Coverage Q-0261 (Rev. 71, Issued: 05-13-11, Effective: 5-13-11-Implementation: 05-13- 11) §416.52(a) Standard: Admission and Pre-surgical Assessment: Not more than 30 days before the date of the scheduled surgery, each patient must have a comprehensive medical history and physical assessment completed by a physician (as defined in section 1861(r) of the Act) or other qualified practitioner in accordance with applicable State health and safety laws, standards of practice, and ASC policy. (Please check your state and accrediting body requirements to ensure you will not be held to a more stringent timeframe).

Every time a patient enters a surgery center, they entrust their life to the facility and its staff. A patient rightfully expects that every precaution will be taken to keep them safe while in the center’s care. Strict policies and procedures are in place to ensure that everyone, physicians included, follows patient safety rules.

Thanks to advances in technology, many historically complex orthopedic and spine procedures have become much less invasive. As a result, many of these cases are now well-suited for outpatient environments, especially ASCs, which have a strong track record of affordable, quality care and positive patient outcomes.

Mike Williams is production manager for a small manufacturing company in middle Tennessee. He and his wife bring home around $52,000 per year, which is the average annual income for families in the US. Mike and his family get their health coverage from an exchange plan that costs $13,000 per year, or about one-fourth of their annual income, before providing any actual health services. Earlier this year, Mike injured his knee playing football with his two sons, which earned him a visit to an orthopedic surgeon and the need for a knee arthroscopy. After receiving a quote from the hospital for $9,200 and considering his $5,000 deductible and 20 percent coinsurance, Mike decided to live with his knee pain.

Change remains the one constant in health care today. From payer behavior to increased patient financial responsibility, and price transparency to value-based medicine, old assumptions are no longer valid.

Data is helping leading health care organizations find clarity in this new landscape, clinically and operationally. Increased information sharing across health systems is leading to better outcomes, as opportunities for collaboration and access to high-quality specialty care increase. It is also helping executives and managers make better business decisions faster.

A strong, effective board can transform an organization from good to great and position your ASC as the leader in your market. Conversely, a weak, disengaged board can drive an organization slowly into the ground, making uninformed decisions and missing competitive opportunities. Since you meet with your board only a limited number of times each year, the effectiveness of those meetings is an important aspect of the effectiveness of your board.

ASCs today are adapting to multiple shifts in the health care and financial environments. Among the many challenges they face as this evolution continues are changing reimbursement, more knowledgeable patients who evaluate their health care options with that knowledge in hand and increased competition from hospitals that purchase physician practices.

Having served in the US
Navy, I cannot help but see
many similarities between
an ASC administrator and
the captain of a ship. Like a
ship captain, the administrator has ultimate
responsibility for the organization,
which is serving a mission where
lives are often at stake. The success
of the mission relies on the team and
its leadership.

There is no doubt the health
care landscape is changing.
Burgeoning health care
expenditures, our aging
and active population
and advances in medical technologies
are fundamentally changing the way
everyone views health care. Massive
consolidation in virtually every sector
of health care is dramatically shifting
the playing field, and these mergers
have enormous implications for the ASC
industry. ASCs are uniquely capable
of reacting quickly to all these changes,
and the ASC industry’s strategic position
within this competitive health care environment
will likely trigger unprecedented
growth in the number of surgeries performed
at ASCs.